Survey of 726 geriatric anesthesia cases of the age over 80 years

The chance to operate on a patient over 80 years old has increased about 1.2 times in the past five years here at OKINAWA CHUBU Hospital. Okinawa Prefecture has the longest life expectancy rate in all Japan. A retrospective study was done on 726 operations involving patients over 80 years of age from March 1983 to February 1988. Preoperative complications included hypertension (37%), arrhythmia (27%), ischemic heart disease (22%) and chronic obstructive pulmonary disease (22%). About 60% of the patients had unstable blood pressure intraoperatively which required treatment with antihypertensives or varopressor agents. The foremost postoperative complications were asthma attacks and pneumonia (12%). Six patients who had painles myocardial infarc-tion either during the intraoperative or postoperative period, all had preoperative cardiovascular complications. The mortality rate within one month of Surgery was 4.9% and was significantly higher in emergency operations, Physical Status 4, general surgery and neurosurgery. There was no significant difference in the mortality rates of octagenarians and nonagenarians, so we concluded that operations on the latter are not contraindicated if the operation will improve activity of daily living.